In honor of this weekend’s Fourth of July — a high summer holiday celebrating America, where concern over this issue has become something of a national pastime — I’d like to share a few observations on a topic that is as mundane as it is pervasive. It happens to be one that has fascinated and frustrated me from virtually the first moment I set foot in South Asia.
I’m referring, of course, to the topic of Privacy.
But not in the N.S.A. sense. Think much more basic.
Every culture has its own norms and boundaries when it comes to privacy. What varies, of course, is where those boundaries fall. For instance, take bathing in public. By necessity, this is a normal feature of Nepali village life. Most of my neighbors don’t enjoy the convenience of their own running water at the turn of a tap, and must instead fill enormous jugs each morning and evening to haul their family’s daily water supply from a communal well. So if our neighbor down the road wishes to bathe, she does so in a sort of “bathing sari” — which, I’m told, requires remarkable skill. Even with the astonishing ability to do so modestly, it remains a relatively public act.
The same is true of a man urinating at the side of the road. (Bear in mind, of course, that interstate rest-stop pavilions have not yet found their way to Nepal. Neither, for that matter, have interstates.) By convention, then, it is considered rude in the extreme for another person to so much as glance in his direction at that indiscreet time. The owness is on us, the passing public, to make a separate space for the person who, out of necessity, is doing this generally “private” act in the open.
Interestingly, it’s the opposite in America; by unspoken agreement, we generally consider it the person’s responsibility to hide him/herself as much as possible – inconveniently venturing deep into the roadside brush, for instance, to relieve oneself on the side of the highway. (The combination of poisonous snakes and sheer cliffs, however, make that a decidedly unappealing prospect here.)
The converse holds true, however, for medical results and other matters that, in the West, we would consider highly confidential. Imagine sharing a brief interaction with your patient at a nursing station back home. (I know, I know, a HUGE No-No! But bear with me for a moment…) Even when sharing something as innocuous as the result of a thyroid test, everyone in earshot would turn away, making it very clear through their body language that they wish to intentionally protect a private area for us. In other words, others take it upon themselves to provide privacy; it is their burden, by social contract, to create that space.
Think how strange it would be, then, if you noticed a complete stranger nearby obviously eavesdropping on that conversation, even craning their neck to hear more clearly! For us, that kind of behavior is implicitly prohibited by the social order, and therefore considered quite awkward.
Yet in my experience here, on the rare occasion that I forget to share a result with a patient after her visit in our Female OPD [“Out Patient Department”] clinic, and have to chase her down in the corridor to speak with her, we are immediately surrounded by a cadre of twenty other women. They all chime in with helpful suggestions, repeating and clarifying my instructions, even clamoring to relate their own prior experiences: When I got my thyroid checked… Oh, I had that kind of ultrasound myself once… Don’t worry, it’s easy… First go to counter #3, then down the hall to room #9… She is being guided by other women who have walked this path before her. It’s as if this kind of sharing is a normalizing experience, a source of comfort for the patient. It represents the secure presence of community surrounding her — in a society that values community above just about anything else.
Yet I know a lot of folks back home (myself included!) for whom this aspect of culture would drive them crazy. For most Americans, it amounts to an extreme — and extremely distressing — breach of privacy. Which simply illustrates a crucial point: “rudeness” in one culture may well be the preferred and socially accepted norm in another. And vice versa. One culture’s “invasion of privacy” may well be another culture’s standard of decency, their expected “requisite help.” Our own specific cultural norms, rather than some universal understanding, are often what dictate “appropriate” behavior for prescribed circumstances.
When trying to navigate the cross-cultural experience, it’s wise to bear that in mind.